Download or read book Effectiveness of Bright Guidelines in Self monitoring of Blood Glucose Among People with Type 1 and Type 2 Diabetes written by Ghafoor Erum and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Title: Effectiveness of BRIGHT guidelines in self-monitoring of blood glucose among people with type 1 and type 2 diabetes.BackgroundThe burden of Diabetes is continuously increasing rapidly due to lack of healthcare infrastructure, insurance policies and coverage, the high cost of health care and non-existence of locally affordable guidelines. 'Advisory Board for the Care of Diabetes (ABCD) of Pakistanu201d has taken the initiative and established BRIGHT guidelines for the self-monitoring of blood glucose levels for people with Diabetes. These guidelines recommend four patterns of SMBGs in form of tables (Low- intensity, moderate intensity, medium intensity and high intensity). Each table recommends the different frequency of self-monitoring of blood glucose as per individualu2019s specific educational, behavioral or clinical requirements in order to identify, prevent and manage acute hyper- and hypoglycemia.Aims:- To evaluate the efficacy of bright guidelines in the monitoring of blood glucose levels among people with type1 and type 2 Diabetes at Karachi, Pakistan.- To access the overall impact of structured monitoring of Blood glucose on metabolic control in people with type1 and type 2 DiabetesMethodPeople with Diabetes who were registered Baqai Institute of Diabetology and Endocrinology and had been given direction to use specific SMBG protocols from Bright guidelines at least 3 months back were invited to participate in this study. A pre-designed questionnaire was administered after three months on the follow-up visit to collect the data regarding the self-report of the implementation of suggested SMBG protocols from Bright guidelines and patients written records were collected to assess the degree of implementation in terms of percentage of suggested tests done. Clinical Data and HbA1c values were retrieved from hospital records and also collected on the follow-up visit to compare the metabolic status. Subjects were categorized Good fair and poor followers of Bright guidelines on the basis of their verbal reports and submitted SMBG records. The difference in HBA1c on the day of data collection and 3-5 months before the data collection was calculated. Association between the implementation of bright guidelines and improvement in glycemic control was explored by comparing mean difference in hba1c in good and poor followers. Data was recorded and analyzed in SPSS version 19.0.ResultsPercentage of compliance to Bright Guidelines ranged from 20 to 100 %. Subjectsu2019 self-reports had the significant positive association with diabetes educatoru2019s records based assessment of implementation. Out of those who claimed implementation only 7.1% were categorized as poor followers while among those who did not claim implementation 87% categorized as poor followers. For good followers mean HbA1C had declined by 1.4% whereas it was raised by .6% for poor followers and this difference was statistically significant (P=0.004).There was no significant difference between type 1 and type 2 diabetics in terms of degree of implementation of Bright Guidelines. Fear (45%) was the most frequently mentioned reason for not following the guidelines followed by lack of time (36%), cost (11%) and forgetting (4%).DiscussionBright guidelines have potential to have a positive impact on glycemic control of both type 1 and type 2 people with Diabetes. Strategies to increase subjectsu2019 motivation are required to improve the degree of implementation.

Download or read book Self Monitoring of Blood Glucose in Patients with Type 2 Diabetes Mellitus Meta Analysis of Effectiveness written by U. S. Department of Veterans Affairs and published by Createspace Independent Pub. This book was released on 2013-06-18 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt: According to the World Health Organization, at least 180 million people worldwide suffer from diabetes. Though prevalent throughout the world, diabetes is more common (especially type 2) in more developed countries like the United States. The National Diabetes Information Clearinghouse estimates that diabetes costs $132 billion in the United States alone every year. Given these estimates along with the projection that the worldwide incidence of diabetes will double in the next 20 years, 1 intensified research into better management of this chronic disease is paramount. Tighter control of blood glucose is advocated as a means to reduce microvascular and macrovascular complications. VA has performance measures assessing the proportion of patients meeting certain A1c goals, currently 7% and 9%. Theoretically, self-monitoring of blood glucose (SMBG) can improve compliance with recommendations on diet and exercise and medication regimens. The American Diabetes Association has recommended that the optimal frequency of SMBG for patients with type 2 diabetes should be adequate to facilitate reaching glucose goals. This hypothesis is based on the expectation that life style changes are facilitated by SMBG. Under these conditions, we should expect an improvement of glycemic control SMBG may decrease patient management costs, and because of the high prevalence of type 2 diabetes, efforts to establish the efficacy of SMBG in type 2 diabetes mellitus are of greater relevance. Methods to achieve improved glycemic control, and therefore a higher proportion of patients meeting target A1c levels, include diet, exercise, and medication. However, evidence supporting the use of SMBG for diabetics not requiring insulin is not as clear. The purpose of this review is to analyze the literature to answer four key questions given to us by VA: 1) Is regular self-monitoring of blood glucose effective in achieving target A1c levels for patients with type 2 diabetes?; 2) Is regular self-monitoring of blood glucose effective in maintaining target A1c levels for patients with type 2 diabetes?; 3) Does regular self-monitoring of blood glucose reduce the frequency of hypoglycemia in patients with type 2 diabetes?; 4) Is there evidence that different frequencies of testing result in differences in improvements in A1c?

Download or read book Systematic Review on Self Monitoring of Blood Glucose for Non Insulin Using Type 2 Diabetes Patients written by Shan Xiao and published by . This book was released on 2017-01-26 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "Systematic Review on Self-monitoring of Blood Glucose for Non-insulin-using Type 2 Diabetes Patients" by Shan, Xiao, 肖珊, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: The increasing prevalence causes great burden to global health. Although there is not yet an agreement on the effect of SMBG for non-insulin-treating type 2 DM patients in comprehensive management, some guidelines recommended all diabetes patients should conduct SMBG. This literature review of 5 meta-analyses and 13 randomized controlled clinical trials assessed the effectiveness of SMBG in glucose control (HbA1c), detection of hypoglycemia, non-glycemic outcomes and potential influence factors(duration of diabetes, baseline HaB1c level, SMBG frequency, SMBG duration, co-interventions) of SMBG efficacy on type 2 diabetes patients not using insulin. The method of this literature review is through a comprehensive electronic literature search of Ovid MEDLINE, EMBASE, the Cochrane Library and China Journals Full-text Database. Both English and Chinese language literatures were reviewed. All meta-analysis and randomized controlled trials of type 2 diabetes non-insulin-using patients taking SMBG to improve the glycemic control and other outcomes were included. In these studies, absolute HbA1c reduction, recognized episodes of hypoglycemia, wellbeing, QALY, DALY, complication morbidity, mortality were used as outcome measures if available. A score list based on the PRISMA Statement was used to evaluate the quality of meta-analyses. 5 meta-analysis all reported a statistical significant but clinical modest-moderate difference in HbA1c reduction between SMBG and non-SMBG group, a new published randomized controlled trial with small cohort enrolled in none of the meta- analyses did not support this conclusion. Evidence showed frequency of SMBG did not influence the efficacy of SMBG, co-interventions as education/consultation, regimen change played a positive roll on SMBG efficacy. Whether baseline HbA1c, duration of diabetes or SMBG itself have an effect on SMBG efficacy was still unknown. There is inadequate evidence of SMBG efficacy of detection of hypoglycemia of patient-oriented outcomes. No eligible Chinese article was defined to enroll in this review. This review did not support to suggest all type 2 diabetes patients not using insulin to conduct SMBG at the frequency the guidelines recommended. Carefully designed and longer-term trials are needed to obtain evidence that is more robust. Further investigation would provide more evidence of the characteristics of potential influence factors, which may help to define the specific population or optimal mode that guarantee the greatest efficacy of SMBG. DOI: 10.5353/th_b4842673 Subjects: Blood sugar monitoring Non-insulin-dependent diabetes

Download or read book Self monitoring of Blood Glucose in Patients with Type 2 Diabetes Mellitus written by and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Diabetes is a prevalent and costly disease in Veterans. Control of blood glucose is an important VA objective. Self-monitoring of blood glucose (SMBG) is advocated as a method to better achieve control. The Key Questions were: Key Question 1. Is regular SMBG effective in achieving target A1c levels for patients with type 2 diabetes? Key Question 2. Is regular SMBG effective in maintaining target A1c levels for patients with type 2 diabetes? Key Question 3. Does regular SMBG reduce the frequency of hypoglycemia in patients with type 2 diabetes? Key Question 4. Is there evidence that different frequencies of testing result in differences in improvements in A1c? METHODS: We searched PubMed from 2004-2006 using standard search terms. We performed an update search in July 2007. Titles, abstracts, and articles were reviewed in duplicate by physicians trained in the critical analysis of literature. Data were extracted by quantitative analysts. Pooled analyses were performed for trials with A1c outcomes at six months and 12 months or greater of follow-up. All other data were narratively summarized. RESULTS: We screened 52 titles, 14 were rejected, and we performed a more detailed review on 38 articles. From this, we identified 14 randomized controlled trials (RCTs) that measured the effect of SMBG compared to a group not receiving SMBG and monitored A1c levels with at least three months of follow-up. Four trials were excluded; one because it presented duplicate data and three because they evaluated SMBG in both the control and intervention groups, leaving 10 trials contributing to the efficacy analysis. We identified five observational studies assessing effectiveness in diabetic Veterans.

Download or read book Diabetes Sourcebook written by Karen Bellenir and published by Omnigraphic, Incorporated. This book was released on 2008 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: According to the Centers for Disease Control and Prevention (CDC), the number of people in the United States with diagnosed diabetes has more than doubled in the last 15 years, but many cases-an estimated one in three-remain undiagnosed. Recent statistics suggest that a total of nearly 21 million Americans have diabetes, and another 54 million U.S. adults have prediabetes, placing them at high risk for developing the disorder. Diabetes is one of the leading causes of death and disability in the United States, and its long-term complications can affect almost every part of the body. Although there is no known cure, proper management, including lifestyle changes, early detection, and education about diabetes self-management, can help prevent the onset of diabetes among adults at high risk and reduce the burden of diabetes complications. Diabetes Sourcebook, Fourth Edition contains updated information for people seeking to understand the risk factors, complications, and management of type 1 diabetes, type 2 diabetes, gestational diabetes, and monogenic forms of diabetes-those that result from mutations in a single gene. It offers information about lifestyle modifications related to delaying the onset of diabetes and managing its course after it has been diagnosed. It discusses medical interventions, including the use of insulin and oral diabetes medications, self-monitoring of blood glucose, and complementary and alternative therapies. Diabetes complications, including eye disease, gum disease, nerve damage, and kidney problems, are also addressed. The book concludes with a glossary of related terms and directories of information for people with diabetes or kidney failure. Book jacket.

Download or read book Effectiveness of Telemedicine Technologies for Improving Glucose Control in Patients with Type 2 Diabetes Mellitus written by Katherine St. Jacques and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Uncontrolled diabetes mellitus is the seventh leading cause of mortality and the leading cause of blindness, kidney failure, and non-traumatic amputations in the United States. A high prevalence of type 2 diabetes mellitus (T2D) has placed a strain on health care systems due to costs associated with anti-diabetic medications as well as diabetes-associated morbidities and disabilities. Traditionally, medical care providers have prescribed lifestyle and medication changes during clinical face-to-face visits, however these visits are costly and are often not effective for producing desired changes in self-management techniques. Evidence shows that the current standard of care often fails to deliver on achieving evidence-based recommendations for glycemic control for patients with diabetes. Recent advancements in telemedicine technologies have emerged as promising platforms which can deliver diabetes management services while reducing unnecessary use of health care resources. Different technological approaches may vary with regard to patient glycemic control outcomes, and cost differences should be taken into consideration when selecting the technology that may provide the greatest overall benefit for the patient. Many newer glucometers have transmission capabilities, allowing these meters to link to smartphone Apps or websites. Patients can measure their glucose levels, share results with their healthcare team in real time, and talk over the phone or through video visits for medication or lifestyle interventions, all in a more expedient manner compared to traditional face-to-face visits. Remote monitoring of blood glucose levels by clinicians has been shown to be feasible and acceptable for patients with both type 1 diabetes mellitus (T1D) and T2D. With this background in mind, the aim of the current review was to evaluate the effectiveness of remote blood glucose monitoring compared to continuous glucose monitoring (CGM) for lowering HbA1c in adult patients with T2D. PubMed was searched for randomized controlled trials, clinical trials, and systematic reviews that included either remote blood glucose monitoring, CGM, or both, and individual interventions had to be longer than six weeks in duration. Studies also had to include adult patients with T2D and had to examine the outcome of change in HbA1c as the primary or secondary outcome of interest. Inclusion and exclusion criteria were determined a priori, and searches included a variety of search terms yielding 92 records, of which 27 articles met the inclusion criteria. Study findings suggested that both remote blood glucose monitoring and CGM are effective for reducing HbA1c in patients with T2D compared to controls. Both the absolute treatment means, and the average treatment mean differences suggest larger reductions in HbA1c in the remote blood glucose monitoring interventions as compared to the CGM interventions. In agreement with previous research, side by side comparisons of the included studies revealed a trend toward greater absolute reductions in HbA1c among all studies where patients had higher baseline HbA1c levels, frequent engagement with the clinical team for more timely and responsive management, as well as algorithm-based treatment plans. Future studies should include a comparison of feasibility, cost of care to implement the interventions, and cost savings to inform clinical decision making, thereby identifying the technology with the greatest overall benefit for patients with diabetes.

Download or read book Diabetes Epidemic You written by Joseph R. Kraft MD MS. FCAP and published by Trafford Publishing. This book was released on 2008-05-07 with total page 133 pages. Available in PDF, EPUB and Kindle. Book excerpt: Revised 04/2011 DIABETES EPIDEMIC and YOU is not a cliché! It is a mandate for the awakening of the "silent" millions worldwide with "normal" fasting blood sugars and undiagnosed diabetes. If you have a "normal" fasting blood sugar, YOU may be one of the undiagnosed millions. YES, I do mean YOU. Since Hippocrates' time, earliest diagnosis provided the greatest opportunity for treatment and cure. This book highlights the earliest identification of type 2 diabetes by utilizing the insulin assay with the oral glucose tolerance. My cumulative experience of 14,384 oral glucose tolerances with insulin assays established the earliest diagnosis of prediabetes and diabetes when the blood sugars were normal. Prediabetes is type 2 diabetes. The tolerances were separated according to age groups, from 3Ð13 years to 81Ð90+ years. Each group was further divided into normal glucose tolerances, impaired glucose tolerances, and diabetes mellitus glucose tolerances. YOU, upon testing by oral glucose tolerance, will be in one of these categories. This resource of oral glucose tolerance with insulin assay is unequaled in world medical literature. The importance of early diagnosis is that the clinical pathology of diabetes – mainly heart disease, high blood pressure, stroke, cataracts, erectile dysfunction, and other metabolic disorders – occurs not only in those with advanced diabetes, but also in those with "normal" blood sugars. YES, this could happen to YOU! When early diagnosis is coupled with specific therapy, the DIABETES EPIDEMIC will be arrested and then reversed. Early diagnosis is the goal of this book – beginning with YOU.

Download or read book Fast Facts Type 2 Diabetes written by Pam Brown and published by Karger Medical and Scientific Publishers. This book was released on 2021-01-26 with total page 150 pages. Available in PDF, EPUB and Kindle. Book excerpt: Fast Facts: Type 2 Diabetes provides a practical overview of this increasingly common health condition. Written by and for health professionals working in primary care, this colourful and accessible handbook highlights important practice points that cover: • identifying and managing those at risk of developing type 2 diabetes • multifactorial interventions to prevent and treat complications • monitoring recommendations An indispensable read for anyone wanting to get up to speed with best practice in primary care. Table of Contents: • Epidemiology • Prevention strategies • Diagnosis • Self-management • Lowering blood glucose • Hypertension and dyslipidemia • Monitoring and microvascular complications • Macrovascular complications • Special populations

Download or read book The Type 2 Diabetes Sourcebook written by David Drum and published by McGraw Hill Professional. This book was released on 2006-01-06 with total page 432 pages. Available in PDF, EPUB and Kindle. Book excerpt: The latest guidelines for lasting health from the American Diabetes Association Completely revised and updated, this essential resource for people with diabetes includes new information on the rise of type 2 diabetes in children, metabolic syndrome, and the most recent recommendations for diet and exercise. It also provides up-to-the-minute findings on the new diabetes drugs on the market and updated lab test and clinical practice guidelines from the American Diabetes Association.

Download or read book Diabetes written by Kirby Campbell and published by Freegulls Publishing House. This book was released on 2024-01-24 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the rapidly evolving world of health and medicine, understanding conditions such as diabetes has become invaluable. Diabetes is a complex and common condition that affects millions of people worldwide, and its impact extends beyond the individuals living with it. It affects families, communities and society as a whole. This book is a source of knowledge and insight into a condition that is increasingly affecting people of all ages and backgrounds. From type 1 diabetes , which teaches us about the unpredictable nature of autoimmune responses, to type 2 diabetes, where lifestyle plays a significant role, we explore the different facets of this condition and provide in-depth insight into its symptoms, causes and facts that are associated with it. This book is for anyone interested in health and wellness, whether you are someone living with diabetes, know someone who has diabetes, or are simply curious about the topic. We will unravel the complexity of diabetes and provide practical information that can contribute to a better understanding and more effective management of this condition.

Download or read book Diagnosis and Management of Type 2 Diabetes written by Steven V. Edelman and published by . This book was released on 2005 with total page 356 pages. Available in PDF, EPUB and Kindle. Book excerpt: Practical management of glucose intolerance is discussed from nonpharmacologic techniques to various pharmacologic therapies. Current prescribing guidelines for oral agents are included, along with information on the various insulin regimens. Guidance is provided on analyzing home glucose monitoring results.

Download or read book Learning to Manage written by Ifunanya Hilda Ejebe and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The management of type 2 diabetes in the United States is a population health priority. Approximately 1 in 10 adults in the United States have diabetes and a significant majority have inadequately controlled blood glucose, blood pressure, and cholesterol. Previous research shows that many adults with diabetes lack the knowledge, skills, behaviors, and support to properly manage their condition. Diabetes self-management education has become an important part of diabetes care guidelines as a way to improve the self-management of adults with diabetes in order to lead to improve patient health and reduce inappropriate health care use and medical costs. Despite this, it is unclear who is actually receiving diabetes self-management education in the US, overall and by mode of delivery and diabetes educator type, and whether education is associated with improved population health. Therefore, the objective of this dissertation research is to investigate the distribution of diabetes self-management education, patient sociodemographic factors that influence the receipt of that education, and its contribution toward diabetes outcomes, medical expenditures, and healthcare use in US adults. We achieved this research objective by completing three specific research aims. We used nationally representative data from the Medical Expenditure Panel Survey and the National Health and Nutrition Examination Survey. We found that although a substantial majority of individuals received some form of diabetes self-management education, receiving diabetes education was associated with race/ethnicity and income (Aim 1), and varied by mode of education delivery. Individuals who received diabetes self-management education were less likely to have glycemic control but were more likely to receive antiglycemic treatment (Aim 2). Receiving diabetes self-management education was associated with greater diabetes-related ambulatory and prescription use, depending on the mode of education delivery (Aim 3). Our findings highlight some strengths of the current state of diabetes management occurring in usual care, including the widespread delivery of some form of diabetes education and its association with greater ambulatory and prescription use. However, we also found evidence of the need for more effective diabetes education delivery systems in usual care in order to improve patient self-care behaviors and reduce inpatient and emergency room use.

Download or read book Efficacy of Self Monitoring of Blood Glucose with and Without Behavior Modification for Control of Type II Diabetes Mellitus written by Margaret Elizabeth Forys and published by . This book was released on 1989 with total page 162 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Secret To Controlling Type 2 Diabetes written by Rao Konduru (Dr) and published by . This book was released on 2019-05-04 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: Type 2 Diabetes Management With Healthy Diet, Oral Medication Or Insulin & Exercise (Applicable Type 1 Diabetes As Well). You Will Learn: (i) The Hidden Secret in The Hemoglobin A1c Chart!, (ii) How to Find Out Your Daily Average Blood Glucose Level!, (iii) How to Control Type 2 Diabetes With Diet & Exercise!, (iv) How to Control Type 2 Diabetes With Diet, Oral Medication & Exercise!, (v) How to Control Type 2 Diabetes With Diet, Insulin Shots & Exercise!, (vi) How to Control Type 1 Diabetes With Diet, Insulin Shots & Exercise! (vii) How to Lower Your Hemoglobin A1c to Perfectly Normal!, (viii) How to Slash After-Meal Glucose Spikes & Achieve Normal A1c! (ix) How to Inject Optimal Insulin Dose, and Exercise to Lower After-Meal Spike to Normal.The following are the reasons why you have uncontrolled diabetes: If your hemoglobin A1c result from a laboratory blood test is found to be over 7% or 0.07, your diabetes is said to be uncontrolled. Most diabetics don't know how to control diabetes, and live with elevated A1c level for decades despite trying hard a variety of oral medications, despite the insulin use, and many trips to diabetes specialists.Even the doctors, endocrinologists and board-certified specialists are not equipped with the appropriate knowledge and training skills to transmit the real concept of controlling diabetes to their patients' minds, except leaving their patients in a dilemma of uncontrolled diabetes.The doctors don't teach their patients how to understand the hemoglobin A1c chart with clear concept. As a matter of fact, the secret to controlling diabetes lies in understanding the hemoglobin chart. And nobody ever told you about it, and nobody ever taught you that secret!.Your hemoglobin A1c is not normal because you are not injecting enough insulin at appropriate times except some scheduled doses recommended by your doctor or nurse, and you are not exercising enough. And your doctors have been giving you full freedom to live like the way you want with unhealthy lifestyle.You are not monitoring enough and not researching enough to understand your elevated after-meal glucose spikes, and you lack fine tuning skills.You are partying too much and eating too much with your family and friends every now and then. Your temptation to eat something delicious would lead to loss of control on dietary guidelines, causing you to overeat delicious foods that are made from processed and refined foods. You have been on oral medications for a long time, and did not think about switching to insulin shots because nobody convinced you that insulin is the best medicine to treat diabetes.You lack self-efficacy, self-discipline, motivation, and willpower to achieve normal hemoglobin A1c level.

Download or read book Applicability of the Evidence Regarding Intensive Glycemic Control and Self monitored Blood Glucose to Medicare Patients with Type 2 Diabetes written by Ethan Balk and published by . This book was released on 2007 with total page 83 pages. Available in PDF, EPUB and Kindle. Book excerpt: This technology assessment report on intensive glycemic control and self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus is prepared by the Tufts-New England Medical Center Evidence-based Practice Center (Tufts-NEMC EPC) for a Medicare Evidence Development and Coverage Advisory Committee (MedCAC) meeting. The primary goal of the report is to describe the applicability of the larger, long-duration studies to the nondialysis Medicare population (i.e., people at least 65 years old). The specific questions addressed are described in the Methods chapter (Chapter 2). The Center for Medicare and Medicaid Services (CMS) also requested a brief narrative review of diabetes (both type 1 and type 2), its epidemiology in the US, complications due to the disease and its treatment, intensive glycemic control, and patient monitoring of glycemia.

Download or read book Does Daily Self monitoring of Blood Sugar Levels Improve Blood Sugar Control and Quality of Life for Patients with Type 2 Diabetes who Do Not Use Insulin written by Laura A. Young and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: For the nearly 75% of patients living with type 2 diabetes mellitus (T2DM) who do not use insulin, decisions regarding self-monitoring of blood glucose (SMBG) can be especially problematic. While in theory SMBG holds great promise for sparking favorable behavior change, it is a resource-intensive activity without firmly established patient benefits.OBJECTIVES: The overarching goal was to assess the impact of 3 different SMBG testing approaches on patient-centered outcomes in patients with non-insulin-treated T2DM within the real-world clinic setting.OBJECTIVE 1: Assess SMBG effectiveness on 2 primary patient-centered outcomes, glycemic control (A1c) and health-related quality of life (HRQOL), over 1 year in 450 participants with non-insulin-treated diabetes mellitus (DM) in the following 3 groups: (1) no SMBG testing, (2) once-daily SMBG testing with standard patient feedback consisting of glucose values immediately reported to the patient through the glucometer, and (3) once-daily SMBG testing with enhanced patient feedback consisting of glucose values immediately reported to the patient plus automated, tailored messaging also delivered via the glucometer. OBJECTIVE 2: Evaluate the impact of SMBG on secondary patient-centered outcomes including (1) DM-related quality of life, (2) DM self-care, (3) DM treatment satisfaction, (4) DM self-efficacy, (5) patient-provider communication, (6) hypoglycemia frequency, and (7) health care utilization. OBJECTIVE 3: Conduct qualitative assessments of the patient participant and provider experience for all 3 intervention groups. This objective supports efficient translation of study findings to real-world clinic settings by exploring such issues as patient-provider communications, use of the glucometer and accompanying reports, utility of the treatment algorithm given to providers, and practice burden. METHODS: Using a stakeholder engagement approach, we developed and implemented a pragmatic trial. We randomly assigned 450 patients with non-insulin-treated T2DM in 15 North Carolina primary care practices to 3 arms without masking of treatment assignment: (1) no SMBG, (2) once-daily testing with standard feedback consisting of glucose values being immediately reported to the patient through the glucometer, and (3) once-daily SMBG with enhanced patient feedback consisting of glucose values being immediately reported to the patient plus automated, tailored feedback messaging delivered to the patient through the glucometer following each testing. Coprimary outcomes included glycemic control (A1c) and HRQOL at 52 weeks. RESULTS: A total of 450 patients were randomized and 92.9% completed the final visit. There were no significant differences in glycemic control across all 3 groups (P = 0.74; estimated adjusted mean A1c difference: SMBG with messaging vs no SMBG −0.09% [95% CI, −0.31% to 0.14%]; SMBG vs No SMBG −0.05% [95% CI, −0.27% to 0.17%]). There were also no significant differences found in HRQOL. There were no notable differences in key adverse events, including hypoglycemia frequency, health care utilization, or insulin initiation. CONCLUSIONS: In patients with non-insulin-treated type 2 diabetes, at 1 year we observed no clinically or statistically significant differences in glycemic control or HRQOL between patients who performed SMBG compared with those who did not perform SMBG. The addition of tailored feedback provided through messaging via a meter did not provide any advantage in glycemic control.

Download or read book Get Smart with Type 2 Diabetes written by Amanda Fryer and published by . This book was released on 2021-05-17 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: Self-management guide for people with type 2 diabetes or prediabetes to help them stay well and reduce their risk of diabetes complications. Contains information on what type 1 and type 2 diabetes are, risk factors, medications - DPP4i's, SGLT2i's, sulphonylureas, GLP-1 RA's, insulin types and injection techniques, what to do when sick, physical activity, healthier eating, carbohydrates, snacks, recipes, health professionals who can help, alcohol, hypoglycaemia and hypo treatment, blood tests and pathology results explained, annual cycle of care health checks, blood glucose monitoring and record template, stress and emotional health, health issues resulting from prolonged elevated blood glucose levels, sick day kit checklist template, sick day management plan template, hypo treatment template, GlucaGen Hypo Kit information, DKA - diabetic ketoacidosis, full colour graphics, 160 pages.